Casiglia E, Pauletto P, Mazza A, Ginocchio G, di Menza G, Pavan L, Tramontin P, Capuani M, Pessina A C
Department of Clinical and Experimental Medicine I, University of Padova, Italy.
Acta Diabetol. 1996 Dec;33(4):284-90. doi: 10.1007/BF00571566.
This study evaluated the role of impaired glucose tolerance (IGT) as a risk factor in a general population of 2079 non-diabetic elderly subjects. The 10-year cardiovascular morbidity was similar in normal and IGT subjects. Mortality was greater in IGT, but the Cox equations of the hazard rate were different in younger and older subjects: age, sex, lung function (forced expiratory volume in 1 s, FEV1), serum uric acid, IGT and proteinuria were predictors of overall mortality in the age class 65-79 years, while only the first 4 were associated with cardiovascular mortality. The same four items also predicted overall survival in subjects over 79 years old, while only age and uric acid were predictors of cardiovascular mortality. In older subjects, total cholesterol showed an inverse predictive value. Hyperuricaemia (> 6.4 mg/dl) and proteinuria did predict mortality in normal but not in IGT subjects, while reduced FEV1 (< 60% theoretical) was predictive in all. In 65-79-year old subjects IGT predicted mortality provided that FEV1 was normal, while in those 380 years old IGT was not a predictor. These interrelationships should be taken into account to better understand the factors underlying mortality.
本研究评估了糖耐量受损(IGT)作为2079名非糖尿病老年受试者总体人群中的一个危险因素的作用。正常受试者和IGT受试者的10年心血管发病率相似。IGT受试者的死亡率更高,但年轻和老年受试者的风险率Cox方程不同:年龄、性别、肺功能(1秒用力呼气量,FEV1)、血清尿酸、IGT和蛋白尿是65 - 79岁年龄组总体死亡率的预测因素,而只有前4项与心血管死亡率相关。同样的4项指标也预测了79岁以上受试者的总体生存率,而只有年龄和尿酸是心血管死亡率的预测因素。在老年受试者中,总胆固醇显示出反向预测价值。高尿酸血症(> 6.4mg/dl)和蛋白尿在正常受试者中确实可预测死亡率,但在IGT受试者中则不然,而FEV1降低(<理论值的60%)在所有受试者中都具有预测性。在65 - 79岁的受试者中,若FEV1正常,IGT可预测死亡率,而在80岁及以上的受试者中,IGT不是一个预测因素。应考虑这些相互关系,以便更好地理解死亡率背后的因素。